NPI | 1891243069 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: VA 0110005488) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110-005488) |
Enumeration Date | 2016-09-16 |
Last Update Date | 2024-08-22 |